Waist-to-height Ratio, a Simple and Practical Index for Screening of Adolescent Metabolic Syndrome Aged 17~19 Years

Abstract

Purpose: To evaluate the validity and usefulness of the waist circumference-to-height ratio (WHtR) in screening for metabolic syndrome in Korean adolescents aged 17∼19 years. Methods: Data (body mass index, waist circumference, and height) and blood samples were obtained from adolescents in A University Hospital in 2011. This study included 554 adolescents (176 boys and 378 girls) aged 17∼19 years. Dependent variables were systolic and diastolic blood pressure, fasting blood glucose (FBS), total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C). Using the Pearson's correlation analysis and logistic regression analysis, we measured the WHtR against Body mass index (BMI). Results: An assessment was carried out of the ability of the 2 indexes to 1) account for the variability in each metabolic risk factor and 2) correctly identify adolescents with metabolic risk factors. The results revealed that the predictive abilities of the waist-to-height ratio index were better values. The waistto-height ratio showed superior values in predicting concentrations of DBP, FBS, TC, TG and LDL-C. However, BMI showed better values in identifying adolescents with high systolic blood pressure and HDL-C. 3) Normal weight adolescents (BMI: 5 th ≤BMI＜85th percentiles) were divided by WHtR (obesity cutoff value: ≥0.51 in male, ≥0.49 in female). WHtR was better than the BMI index for signaling metabolic risk in the normal-weight adolescents. Conclusion:The WHtR is a better predictor for finding metabolic risk factors in adolescents aged 17∼19 years with normal BMI. The WHtR is proposed as an alternative, convenient measure of screening metabolic syndrome for adolescents aged 17∼19 years independent of age and sex. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 385∼392)

Influencing Factors for Cardiometabolic Risk in Korean Adolescents Based on 2010–2015 Data From the Korea National Health and Nutrition Examination Survey

“…However, when the WHtR of 0.47 or higher was applied, the obesity rates increased to 23.6% and 18.0% for males and females, respectively. This supports previous MetS studies in adolescents, 18,22 The WHtR is more suitable for finding hidden obesity and can be used to identify adolescents with normal body mass index who are still at risk for MetS.…”

“…However, when the WHtR of 0.47 or higher was applied, the obesity rates increased to 23.6% and 18.0% for males and females, respectively. This supports previous MetS studies in adolescents, 18,22 The WHtR is more suitable for finding hidden obesity and can be used to identify adolescents with normal body mass index who are still at risk for MetS. When comparing gender, WHtR, high blood pressure, smoking, and drinking were significantly higher in male adolescents, and dyslipidemia, increased waist circumference, aerobic and strength exercises, and perceived stress were higher in female adolescents.…”

“…17 However, whereas authors of most previous studies measured the correlation of obesity based on body mass index or waist circumference in adolescents, 1,2 authors of recent studies have found the waist-to-height ratio (WHtR) to be a sensitive and useful indicator for adolescents with increased cardiometabolic risk. 13,18 In adolescents, it is difficult to differentiate between muscle mass and body fat, and they grow rapidly; consequently, it is necessary to use WHtR, not waist circumference or as body mass index, to determine the relationship with cardiometabolic risk. The purposes of this study were (1) to investigate differences in MetS prevalence and individual risk factors according to gender using the Korea National Health and Nutrition Examination Survey (KNHANES) and ( 2) to identify factors associated with cardiometabolic risk group (risk factor ≥ 1) using WHtR for obesity.…”

“…Obesity, a major risk factor for MetS, in adolescents was found to be the strongest predictor of the development of MetS in adulthood, according to a Finnish cohort study 17 . However, whereas authors of most previous studies measured the correlation of obesity based on body mass index or waist circumference in adolescents, 1,2 authors of recent studies have found the waist-to-height ratio (WHtR) to be a sensitive and useful indicator for adolescents with increased cardiometabolic risk 13,18 . In adolescents, it is difficult to differentiate between muscle mass and body fat, and they grow rapidly; consequently, it is necessary to use WHtR, not waist circumference or as body mass index, to determine the relationship with cardiometabolic risk.…”